Invasive evaluation of the hemodynamics and anatomy of congenital heart disease has been the principal activity in the Pediatric Cardiac Catheterization Laboratory directed by Delores Danilowicz, M.D. The data are utilized to direct surgical intervention and plan appropriate pre and post-operative care. With the advent of increasingly sensitive and specific noninvasive modalities, the goals in the cardiac catheterization laboratory are changing from diagnostic to therapeutic/interventional catheterization.

Routine interventional procedures include: balloon valvotomy for pulmonic and aortic stenoses, balloon angioplasty for branch pulmonary artery stenosis and recurrent coarctation of the aorta. In addition to these, current interventional research and clinical protocols are: a) Trans-catheter coil occlusion of congenital and acquired aorto-pulmonary communications in patients with congenital heart disease. b) Balloon expandable intravascular stents in congenital heart disease.

The first protocol is to study the efficacy and long term sequelae of non-surgical coil (Dacron stranded stainless steel coils) occlusion of a patent ductus arteriosus, aorto-pulmonary collateral, or systemic-pulmonary venous fistulae. This non-surgical technique significantly reduces the morbidity and mortality associated with the surgical correction of such lesions. The second protocol is an alternative method to the management of recalcitrant obstructions in branch pulmonary arteries, systemic arteries, and systemic veins. The efficacy and long-term results of this technique are to be compared to surgical intervention of such obstructions. Representative